Individual
ALICIA S BALISTRERI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5735 DURAND AVE, MOUNT PLEASANT, WI 53406-5011
(262) 598-1392
Mailing address
5735 DURAND AVE STE A, MOUNT PLEASANT, WI 53406-5011
(262) 598-1392
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16353-131
WI
Other
Enumeration date
09/17/2020
Last updated
09/17/2020
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